Editorial Commentary: Finally, a Salvage Procedure for Hip Capsular Insufficiency!
Authors: Domb BG, Meghpara MB
DOI: 10.1016/j.arthro.2020.02.039
Background
Capsular insufficiency—whether from over-resection, trauma, or failed prior repair—can compromise hip joint stability and lead to persistent symptoms post-arthroscopy. While capsular repair or plication is the standard approach, there’s growing interest in capsular reconstruction as a salvage option.
Methods
This editorial evaluates the evolving role of capsular reconstruction, particularly in the setting of failed repairs or severe instability. It provides expert commentary on current literature and the direction of future practice.
Key Findings
- Capsular reconstruction shows early promise as a reliable technique to restore stability in cases of capsular deficiency.
- It may serve as a critical option in revision hip arthroscopy or in patients with generalized ligamentous laxity.
- Emphasis is placed on careful surgical planning and recognition of insufficient capsular tissue as a significant pathology.
Conclusions
Capsular reconstruction should be considered in the algorithm for managing refractory hip instability. It offers a viable surgical solution when standard capsular repair is not feasible or has failed.
What Does This Mean for Providers?
In cases of capsular insufficiency—particularly after failed plication or in revision settings—capsular reconstruction provides a promising salvage strategy. Surgeons should be familiar with this technique and consider it when addressing patients with persistent instability and insufficient native capsule.